Gov. Dave Heineman says the state has time to implement the federal healthcare law’s provisions and advises a slow, careful implementation of the law.

Heineman remains an opponent of the 2010 law now upheld by the United States Supreme Court. He says the next big test facing the law will occur during the elections in November. Heineman suggests that if Republican Mitt Romney defeats President Barack Obama, there could a chance to overturn the law.

Still, the state has been planning creation of the healthcare exchange required of states by the law. Heineman says the federal Department of Health and Human Services is sure to release new guidelines in wake of the Supreme Court ruling.

Heineman says how the state proceeds depends on whether it decides to expand Medicaid. Heineman says those covered under the Medicaid expansion would have a different plan than those currently under Medicaid.

“So, you’re going to have to have the technology to integrate all of that, it would be more complex and cost more money,” Heineman contends. “That’s why I say it I think we need to proceed very carefully.”

The law calls for the federal government to pay the entire cost of the Medicaid expansion the first three years, then 90% thereafter. Heineman doubts federal funding would remain at 90%. He predicts it will drop over the years.

Heineman says Congress missed an opportunity when it approved the federal healthcare law. Heineman says the federal law fails to emphasize wellness and fails to keep healthcare costs in check.

Heineman concedes that an expansion of Medicaid would provide health care coverage to Nebraskans now uninsured, now estimated at between 11 and 13% of the state population.

“Certainly, that 11-to-13% I think would come down some. How much, we don’t know.” Heineman says. “I also think there’s a good argument it would almost be cheaper to go out and buy health insurance for everybody who’s uninsured than to go through this very complex system that we’re going to go through.”